Gymnast's wrist (pseudorickets growth plate abnormality) in adolescent athletes: findings on plain films and MR imaging
| Autor: | David P. Roye, Carrie Ruzal-Shapiro, R Wilkinson, Walter E. Berdon, Terry L. Levin, M S Liebling |
|---|---|
| Rok vydání: | 1995 |
| Předmět: |
Male
Wrist Joint Gymnastics Cumulative Trauma Disorders business.industry Radiography Bone age General Medicine Metaphysis Wrist Wrist Injuries Magnetic Resonance Imaging Carpal bones Splints medicine.anatomical_structure medicine Humans Radiology Nuclear Medicine and imaging Growth Plate Child business Nuclear medicine Range of motion Metaphyseal irregularity |
| Zdroj: | American Journal of Roentgenology. 164:157-159 |
| ISSN: | 1546-3141 0361-803X |
| DOI: | 10.2214/ajr.164.1.7998530 |
| Popis: | A 13 1/2-year-old boy, who was a competitive gymnast, had pain in both wrists; the pain was worse in the left wrist than in the right. The patient had worked out as much as several hours a day, 5 days a week, over the previous 2 years. The pain primarily was dorsal and radial and was exacerbated most by hanging from the rings and high bar. Physical examination showed full range of motion, pain on fullforced dorsiflexion and palmar flexion, and slight tenderness over the radial aspect of the wrist. Radiographs obtained at another institution were considered normal (Fig. 1A), The bone age was 1 year behind the chronologic age. The patient continued his exercise routine with the use of splints. He returned 3 months later with continued pain, despite treatment with nonsteroidal antiinflammatory drugs. Plain radiographs (Fig. 1 B) showed widening and irregularities of the distal radial physes, which were more prominent in the left radius than in the right. Simiar, but less extensive, changes were present in the distal ulnar physes. The wrist joints and carpal bones had no abnormalities. Bone age still was slightly delayed. Ti-weighted (600/17) MR images corroborated widening ofthe growth plate and the irregularity of the bordering metaphysis (Fig. 1C). On T2weighted gradient echo (600/22, 35 flip angle), most of the metaphyseal irregularity had low signal intensity. However, an additional fine, irregular line near the open growth plate had the same high signal intensity as the growth plate (Fig. 1D). The MR imaging had been requested by the orthopedist in view of the continuing pain and seemingly normal plain films (Fig. 1A) that were obtained 3 months previously (the MR image actually was obtained before the repeat plain films) (Fig. 1B). The patient was advised to discontinue wrist weight-bearing activities. Radiographs ofthe wrist obtained 6 months later showed interval resolution of the growth plate abnormalities. Repeat MR images were not obtained. The patient planned to return to gymnastic training. |
| Databáze: | OpenAIRE |
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